105 Spironolactone May be a Cause of Hormonally Associated Vestibulodynia and Female Genital Arousal Disorder

Abstract

The use of hormone modulating treatments for the treatment of androgen-mediated cutaneous disorders (AMCDs) in women including acne, hirsutism, and female pattern hair loss has been increasing. While these disorders can have a significant impact on women, the importance of androgens in the maintenance of women’s health is often overlooked. Specifically, androgens affect bone density, muscle mass and strength, adipose tissue distribution, mood, energy, and psychological well-being. In addition, androgen play a critical role in women’s sexual desire, arousal, genital sensitivity, and orgasm. The impact of combined hormonal contraceptives (CHC), which are the most prescribed medication for AMCDs, on female sexual dysfunction has been significantly examined in the peer-reviewed medical literature. However, spironolactone, another medication commonly prescribed for AMCDs, has not received the same attention. Spironolactone is an androgen antagonist that decreases the effect of endogenous androgens by competitive inhibition of testosterone and dihydrotestosterone (DHT) binding to androgen receptors. This abstract reports on two cases of women with hormonally associated vestibulodynia and female arousal disorder most likely caused by spironolactone.